Intended for healthcare professionals

Primary Care

Association between falls in elderly women and chronic diseases and drug use: cross sectional study

BMJ 2003; 327 doi: (Published 25 September 2003) Cite this as: BMJ 2003;327:712
  1. Debbie A Lawlor, senior lecturer in epidemiology (d.a.lawlor{at},
  2. Rita Patel,, project coordinator1,
  3. Shah Ebrahim, professor of epidemiology of ageing11
  1. 1Department of Social Medicine, University of Bristol, Bristol BS8 2PR
  1. Correspondence to: D A Lawlor
  • Accepted 18 July 2003


Abstract Objective To assess the associations between having had a fall and chronic diseases and drug use in elderly women.

Design Cross sectional survey, using data from the British women's heart and health study.

Setting General practices in 23 towns in Great Britain.

Participants 4050 women aged 60-79 years.

Main outcome measure Whether women had had falls in the previous 12 months.

Results The prevalence of falling increased with increasing numbers of simultaneously occurring chronic diseases. However, no such relation with falling was found in the fully adjusted data for the number of drugs used. Circulatory disease, chronic obstructive pulmonary disease, depression, and arthritis were all associated with an increased odds of falling. The fully adjusted, population attributable risk of falling associated with having at least one chronic disease was 32.2% (95% confidence interval 19.6% to 42.8%). Only two classes of drugs (hypnotics and anxiolytics, and antidepressants) were independently associated with an increased odds of falling. Each class was associated with an increase of about 50% in the odds of falling, and each had a population attributable risk of < 5%.

Conclusion Chronic diseases and multiple pathology are more important predictors of falling than polypharmacy.


  • Contributors All authors developed the study's aim and design and managed its data. DAL undertook the initial analysis and coordinated the writing of the paper. All authors contributed to the final version. DAL will act as guarantor for the paper.

  • Funding The British women's heart and health study is funded by the Department of Health. DAL is funded by a Medical Research Council and Department of Health training fellowship.

  • Competing interests None declared

  • Ethical approval Local ethics committees approved the study, and 99.4% of participants gave written informed consent for their medical records to be available.

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